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Young homeless women have often suffered violence or sexual assault.
Leaving home to escape this, they often remain vulnerable to violence,
from partners or from others, whether on the streets, or in temporary
accommodation or institutions. They often have no sense of control,
or of a right to have control, of their bodies. Many turn
to sex work or drugs to survive, becoming exposed to sexual abuse,
sexually transmitted diseases, and unplanned pregnancies.
Unsafe sex commonly occurs here for a variety of reasons, including:
- Ignorance of the consequences.
- A sense of invulnerability.
- The naive belief of being protected in a loving relationship.
- Myths about the ability to identify STD (Sexually Transmitted
Disease) sufferers from their physical appearance.
- The lack of a sense of control over the body.
- Powerlessness in managing relationship issues.
- Deliberate risk-taking.
Young people's knowledge of sex and sexuality is often limited.
Information provision is critical, particularly concerning consequences
of actions or inactions. This information should encompass:
- Advice on the risk/prevention of STDs and on facilitating
access to sexual health services. Note that STDs may be symptom-less,
or may cause unusual vaginal discharge, pelvic pains, or begin
with some sort of menstrual change.
- Contraception information.
- Education about responsibility for a partner.
- Negotiating sex and safe sex. Difficult even for very sophisticated
people, this is especially hard for young women. Role-playing
can improve negotiation skills. Analysis of a past episode of
unsafe sex may identify contributing factors and guard against
repetition.
- Education on the need for pelvic examinations in sexually
active young women. A pap smear, and screening for sexually transmitted
disease, may be needed. Past abuse and other factors may cause
anxiety about pelvic examinations. It may be appropriate to explain
the procedure, enquire about concerns, and remove misunderstandings.
Confirm the client's right to decline such an examination either
from the outset or at any time during such an examination.
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